have an ischemic stroke,
and 2.89 times as likely to
be diagnosed with dementia
due to Alzheimer’s disease.

The results were adjusted for
variables such as age, sex,
caloric intake, diet quality,
physical activity and smoking.

Pase and other researchers say the work points clearly
to the need to investigate the possible biological reasons
artificial sweeteners might affect the brain and the need for
more experimental and clinical trials.

“We need to be cautious in the interpretation of theseresults,” said Rachel K. Johnson, Ph.D., past chair of theAmerican Heart Association’s Nutrition Committee andprofessor of nutrition at the University of Vermont. “It doesn’tprove cause and effect. When you see these kinds ofassociations, you want to always ask what is the biologicalplausibility, what is the mechanism that might be causing this?”But, Johnson said, there is a part of the issue that is“settled science.”“We have a robust body of literature on the adverseeffects of sugary drinks. Absolutely the message is not toswitch to sugary drinks,” she said.

Studies linking added sugars and conditions that lead to
cardiovascular disease have been around for years. Diets
high in added sugars have been connected to heart risk
factors such as obesity and high blood pressure.

In 2012, the AHA and the American DiabetesAssociation issued a scientific statement on the use ofartificial sweeteners, saying “that when used judiciously,[artificial sweeteners] could facilitate reductions in addedsugars intake.” The statement called for further research onnon-nutritive sweeteners and cardiovascular risk but notedthat “limiting added sugars is an important strategy forsupporting optimal nutrition and healthy weights.”Consumers shouldn’t “over-interpret” the latest study’sresults, said Christopher Gardner, Ph.D., director of NutritionStudies at the Stanford Prevention Research Center and aprofessor of medicine at Stanford University. Gardner waslead author on the 2012 statement.

“It’s a tricky thing,” said Gardner, who leads research intohow people can optimize their diets. “Nobody ever said dietsodas were a health food.”For many people, such as people with diabetes or obesity,he said, diet sodas can be part of the gradual switch fromsugary drinks.

“So, the bottom line is, ‘Have more water and have less
diet soda,’” he said. “And don’t switch to real soda.”

Pase, who studies how people can change behavior or
diet to prevent dementia, said people need to be skeptical
when deciding whether to select something with artificial
sweeteners or real sugar.

“Just because a beverage is advertised as being healthy
because it doesn’t have any sugar doesn’t mean that it is
healthy,” Pase said. “Artificial sweeteners may have effects in
the body that we haven’t begun to explore.”